New To Medicare? A Guide To Your Initial Enrollment Period

Are you new to Medicare? If you or a loved one are nearing the age of 65 or are otherwise eligible for Medicare coverage, you probably have questions surrounding Medicare enrollment, out-of-pocket costs, coverage and more.

Medicare Initial Enrollment Period Guide

Eligibility

If you’re aging into Medicare (rather than qualifying for another reason, like certain health conditions), you’re eligible to receive Medicare benefits on the first day of the month in which you turn 65. (If you are born on the first of the month, your benefits start the first of the prior month.) If, for example, your birthday is May 27, 1946, your coverage will begin May 1, 2011. You have a period of seven months during which you may enroll. Your Initial Enrollment Period (IEP) begins three months before your 65th birthday, runs through your birthday month, and ends three months after your birth month.

If you’re nearing your IEP, it’s a good idea to start doing your research before it begins. Allow yourself plenty of time to select the Medicare plan(s) that meet your needs and your budget. If you don’t enroll during your IEP, you may pay penalty fees or have to wait until the Annual Enrollment Period (AEP) to make your selection.

Research

There are several Medicare coverage choices available through both government run and privately insured programs, and plan availability varies depending on where you live. It is important to shop around before enrolling in Medicare.

Original Medicare is administered by the federal government and consists of Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). Medicare Part A is of no cost to you if you or your spouse made payroll contributions to Social Security for a minimum of 10 years. You will, however, pay a premium for Medicare Part B, and the amount will depend on your annual income. In 2011, Part B premiums range from $115.40 to $369.10 per month.

Medicare Part D helps pay the cost of prescription drugs. If you’re interested in Medicare Part D you must enroll through a private insurer. If you delay enrolling when you first become eligible, you may pay a penalty on your premium in the future unless you qualify for an exception.
Medicare Advantage (Part C) plans are offered by private insurance companies approved by Medicare. Part C plans combine coverage for hospital stays and doctor visits in a single plan. You may choose a Medicare Advantage plan that includes prescription drug coverage, or select one without.

Medigap, also known as Medicare Supplement Insurance, are also provided by private insurance companies. Designed to help with costs not covered by Original Medicare, there are 10 standardized Medigap plans labeled “A” through “N”. These plans typically cover some coinsurance, deductibles and excess charges that Medicare does not cover. The application process and terms are different for Medigap plans than the other plans discussed here; enrollment isn’t limited to a certain time of year. Read “Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare” for more information.

Enrollment

Once you are eligible and have selected the Medicare plan(s) that you feel best meet your needs, it’s time to enroll. If you’re already receiving Social Security you will automatically be enrolled in Medicare Parts A and B. If you’re not yet receiving Social Security you will need to enroll with your local Social Security office.

In order to enroll in a Medicare Advantage or Medigap Plan, contact the insurance company who provides the coverage you’ve selected. If you miss the Initial Enrollment Period you will need to wait until the Annual Election Period (AEP) to enroll. Again, Medigap plans work a little differently, so read more about Medigap coverage in your state.

Review or Change your Selection Annually

You have an opportunity once a year to change your Medicare Coverage. In 2011, this Annual Election Period runs from October 15 to December 7.
Before AEP begins, it’s a good idea to evaluate your medical costs, your healthcare needs, and any changes that may have been made for the coming year’s plans. This will prepare you to make changes to your coverage selection if you choose to. (Changes in the coming year’s plans are announced by the Center for Medicare Services annually; see www.cms.gov for details.) Unless you qualify for an exception, this is your one annual opportunity to change your Medicare selection.
For more information contact the Medicare helpline 24 hours a day, 7 days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048. You can also contact the UnitedHealthcare® Medicare Made Clear hotline to learn more 1-877-619-5582, TTY 711, 8 a.m. - 8 p.m. local time, 7 days a week.

Y0066_110427_115625 File & Use 05072011

By: AJoyce

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The family of UnitedHealthcare® Medicare Solutions plans are insured or covered by an affiliate of UnitedHealthcare, a Medicare Advantage organization with a Medicare contract and Medicare-approved Part D Sponsor.